Technique Update: One Leg Standing and Health

The inability to stand on one leg for at least 20 seconds is associated with early pathological changes in the brain and cognitive functional decline, even in apparently healthy subjects. The study was published in the American Heart Association’s journal Stroke.

Postural instability was assessed in patients over 50 years old using the eyes open one-leg standing time (OLST). Researchers found that the inability to balance on one leg for longer than 20 seconds was associated with cerebral small vessel disease, primarily small infarctions without symptoms such as lacunar infarction and microbleeds.  Short OLST was also independently linked with lower cognitive scores.

A study by Matsuzawa found that short OLST, in particular under 3 seconds, is associated with decreased physical performance and elevated mortality risk in elderly patients with cardiovascular disease.

Further, a large study carried out by the Medical Research Council in England found that those at age 53 who did poorly on the OLST – they could only manage 2 seconds or less on average – were three times more likely to have died over the next 13 years than those who could stay standing for 10 seconds or more.

The OLST is a simple test of balance that gives a lot of health information, including early signs of being at risk for brain injury and cognitive impairment.


  1. Yasuharu Tabara, Yoko Okada, Maya Ohara, Eri Uetani, Tomoko Kido, Namiko Ochi, Tokihisa Nagai, Michiya Igase, Tetsuro Miki, Fumihiko Matsuda, and Katsuhiko Kohara. Association of Postural Instability With Asymptomatic Cerebrovascular Damage and Cognitive Decline: The Japan Shimanami Health Promoting Program Study. Stroke, December 2014 DOI: 10.1161/STROKEAHA.114.006704
  3. Matsuzawa R, Kamiya K, Hamazaki N, Nozaki K, Tanaka S, Maekawa E, Matsunaga A, Masuda T, Ako J: Office-Based Physical Assessment in Patients Aged 75 Years and Older with Cardiovascular Disease. Gerontology 2019;65:128-135. doi: 10.1159/000493527
  4. Cooper Rachel, Strand Bjørn Heine, Hardy Rebecca, Patel Kushang V, Kuh Diana. Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study BMJ 2014; 348 :g2219
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